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Jen L.
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| Posted: Sept 12 2007 at 9:28am | IP Logged
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I'm hoping someone can offer reassurance to my friend who had a 34 week preemie about 4 weeks ago.
Although she was derailed somewhat at the hospital, now that they are home, she is committed to fulltime breastfeeding. She is 42 and this is her first child (she waited a long time for God to send her the right guy and they just got married 2 years ago) - much anticipated and much loved.
The baby has a great latch and was a "star of the NICU" but they got her obsessed with weight gain. My friend is not getting enough sleep - especially since she is so worried about her weight gain and is concerned that Colette is "not being satisfied" at the breast.
I have to run, I hope this is somewhat understandable.
Thanks in advance,
Jen
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Celeste
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| Posted: Sept 12 2007 at 10:43am | IP Logged
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Sometimes a nursing scale can be reassuring, if weight gain is a serious issue. They can be rented from hospitals or lactation consulting places. (Insurance might pay for the rental if the doctor prescribes it.)
Weigh the baby before feeding (record weight), feed the baby, weigh the baby immediately after (without changing diaper). The scales are sensitive enough to show how many ounces the baby ate. Working with a lactation consultant you can calculate how many ounces the baby needs per day, then divide it up per feeding. You can see, then, if the baby is getting enough milk to gain weight. If not, then there are ways to supplement--maybe breastmilk in a bottle, since that nipple is easier, or milk through a syringe. Sometimes formula is necessary. But having the scale lets you know for sure.
I feel for your friend--I've been there. Not with a preemie, but dd #3 was born with a heart defect that made weight gain imperative to prep her for surgery, but also made breathing (and therefore eating) very difficult. The scale helped me through it--and I ended up not having to supplement with formula, although I was prepared to if she needed it.
Hope that helps!
Celeste
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juststartn
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| Posted: Sept 12 2007 at 10:54am | IP Logged
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GL to your friend on the nursing. My boys were born at 34 wks. THey gained slowly until they left the NICU about 2wks later (they were in there 13 and 16 days). They both were over 5lbs at 17 days post delivery. I pumped like a maniac, but they never would latch (I am so glad for your friend that she can), and had to deal with a diminishing supply after I hit the two month mark, no matter how often I pumped or what herbals I used to increase it (I even tried Reglan...sigh).
I'd have them see about getting her one of those scales if it is a serious concern. I'd also have her do that whole "how many wets/solids diapers is she having each day" thing. Keep track, just kind of informally. Nothing regimented, and make sure she's eliminating regularly and a decent amount...
My boys are probably closing in on 13lbs or so--maybe more, now--and they turned 4 mos on the 7th.
Rachel
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JennGM
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| Posted: Sept 12 2007 at 1:09pm | IP Logged
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My son wasn't a preemie, but he had weight gain problems. He was jaundiced at first, so wanted to sleep through a lot of feedings. We rented a hospital pump and later a scale. He had other problems that we found later (food allergies causing reflux), so most of what went in came up pretty fast.
Is your friend a little nervous that exclusive nursing won't help with weight gain? I know some hospitals really push the formula, but really the baby can be exclusively breastfed and become quite chunky. You should see my sisters' babies. 
What we did: we worked closely with the lactation consultants. I rented the hospital pump. Since ds wanted to sleep through feedings at the beginning, I did feed him on a schedule, almost every 2 hours during the day and about 4 hours at night. I would pump before I started nursing him to get a good letdown and help him get some hindmilk. I would also nurse on both sides. I pumped a lot, and we syringed some breast milk down him if he would fall asleep at the breast.
Ours was a bit extreme measures. We didn't get the scale until later, and that gave me better assurance, because there was doubt that he was latching or feeding properly.
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ann@home
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Another important thing is keep that baby close! I cannot say this enough. Wear the baby in a carrier of some type and try to have as much skin to skin contact. This contact stimulates brain activity in the babe and will help them both get into a rythm.
I hope she's keeping her close at night too. If she's worried about the baby sleeping in the bed there are great co-sleepers and even a basinet can be kept next to the bed so there are less distrurbances of sleep. She'll get more sleep if she can just stay in bed and nurse and then go back to sleep instead of getting up.
And it's so scary and intimidating those first few weeks or months anyway, let alone with a preemie! I hope she can hook up with La Leche league for support, they can be so helpful! And tell her it's not uncommon at all for a baby to seem like they are at the breast CONSTANTLY for the first few weeks. They are just trying to regulate milk production and bond and mom's stress can affect that.
Give her warm wishes from me ;)
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sewcrazy
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All of my babies (5 so far) were preemies (30 weeks to 35 weeks), and all exclusively breast-fed. Worry over weight gain can be such a hurdle for preemie moms. preemies tend to gain weight more slowly than their full term age mates. They are using a lot more calories managing their bodies than a full term baby does, and they consume less calories at a time. They have smaller tummies, and tire out quicker. it is normal for a preemie to nurse for a little bit every hour (or less!)
please encourage your friend to stick with it. The immune benefits alone make it worth all the effort! And as Ann said, lots and lots of skin on skin contact. My littlest came home weighing 3lbs, 6 ounces. He lived in the sling against my bare skin with an extra large mens shirt over both of us.
It is normal for preemies to lag behind for up to 2 years. My littlest is now a strapping 5 foot, 8 inch, 150 lbs, 13 year old boy. All of my children swung over to the high end of the growth curve by 4 years old.
I would be happy to offer any assitance to your friend.
I will keep her in my prayers.
LeeAnn
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Jen L.
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| Posted: Sept 13 2007 at 12:05am | IP Logged
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Thank you! for the advice and prayers.
I am passing it on to her.
Colette was born at 3 lbs 2 oz on August 7th. She came home right around 4 lbs just a week and a half ago.
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c_rob
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I have had 2 preemies - one born at 26 weeks and one born at 30 weeks. Both are now big, strapping girls and neither has a developmental delay - praise God.
I will speak counter-culturally now but, far more important than breast feeding is developing a nurturing relationship with our new babies. If your friend is so anxious that her baby is not satisfied, perhaps she could be encouraged to bottle feed her expressed milk, so that she could monitor the intake. I know! there is nothing like holding your little one to your breast and feeling the life force flow from you to her, but if all that is flowing is anxiety and stress, the baby (and mum) will suffer so much more. If she does choose to take this advice, encourage her to take lots of time to stroke her baby, massage is wonderful and it is relaxing and tactile and a great bonding experience. I find that preeies generally don't gain significant weight until they are 1 - 2 months (corrected) and we can drive ourselves insane by weighing. I weigh mine every two weeks. In the meantime, I judge sufficiency by colour, hydration and wet nappies. Alertness is not approriate because feeding is an exhausting activity and requires far more sleep than other babies. I have a 6 month old as I write and she has been my most difficult - she was not preemie, but was born with an underdeveloped digestive system. She could not metabolise breast milk or any of the regular formulas. We eventually got her on to a pre-digested formula and, at 3 months, she gained her first ounce. I KNOW it's hard. I still say, you have (at least pretend) to be calm if your baby is going to learn that you are in charge, she is safe and it is a good thing to be in this worls.
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4Real Forums : Tea and Conversation
Topic: Help! Preemies and Weight Gain
